Pediatrik öncü B-ALL’ye Moleküler Yaklaşım

Year 2019, Volume: 50 Issue: 2, 91 - 101, 15.06.2019

Dilara Fatma Akın Balı

https://doi.org/10.16948/zktipb.425982

Abstract

Lösemi, çocukluk çağında en sık görülen malign
hastalıktır. Bu hastalık yaklaşık 150 yıl önce tanımlanmıştır, ancak son 30
yıllık süreçte tedavide %90’lara varan bir başarı oranına ulaşılabilmiştir. Bu
başarılı sonuçlara ulaşılmasında çoklu ilaç uygulamaları, santral sinir sistemi
profilaksisi, idame ve destek tedavi uygulamaları etkili olmuştur. Tedavide bu
kadar başarılı sonuçların alınmasına rağmen nüks lösemi için bir risk olmaya
devam etmekte ve ALL hastalarının %20’sinde görülmektedir. Tedaviden alınan
farklı sonuçlar diğer bütün kanser tiplerinde olduğu gibi lösemi’nin de
heterojen bir yapıya sahip olduğunu işaret etmektedir. Bu nedenle erken, doğru
bir teşhis ile daha etkin bir tedavinin ancak kişiye özgü (hastalık alt
gruplarına) tedavi, yöntem ve müdahale stratejilerinin geliştirilmesi ile
mümkün olabileceği öngörülmektedir. Bu kapsamda diğer bütün kanser tiplerinde
olduğu gibi “lösemi genomunda” yapısal ve/veya işlevsel bozukluk gösteren
genler, lösemi tanısı, tedavisi ve nüksünün önlenebilmesi için yeni prognostik
araçlar olabilme potansiyeli taşımaktadır.

Keywords

Lösemi, prognostik biyobelirteç

Molecular Approach to Pediatric Precursor B-ALL

Abstract

Leukemia is the most common malignant disease in
childhood. This disease was identified almost 150 years ago, but in the last 30
years, treatment processes have achieved a success rate of up to 90%. These
successful outcomes were supported by multi-drug treatments, central nervous
system prophylaxis, maintainability and therapeutic applications. Although
successful treatment outcome relapse continues to be a risk for leukemia and is
seen in 20% of patients with leukemia. In this case, all other types of cancers
as well as leukemia have a structure that is heterogeneous. Therefore,
individualized treatment methods are more effective than early accurate
diagnosis, hence the development of individualised treatment methods and
intervention strategies have become necessary. In this context, as in all other
types of cancer the leukemia genome contain structural abnormalities several
genes leading to their functional dysfunction. These genes have the potential
to become novel biomarkers for diagnosis, prognosis, treatment and prevention
of relapse.

Keywords

Leukemia

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